22nd July 2023

A 75-year-old man presents to the emergency department with sudden onset severe generalised abdominal pain

A 75-year-old man presents to the emergency department with sudden onset severe generalised abdominal pain. His history includes hypertension, hyperlipidaemia and a myocardial infarction in 2013, with percutaneous coronary intervention to his left anterior descending coronary artery. He is generally tender across his abdomen, however, his abdomen is soft and non-distended with normal bowel sounds. A contrast CT abdomen and pelvis shows bowel wall thickening in keeping with ischaemia but no evidence of infarction or perforation. A subsequent CT angiogram reveals a filling defect in the superior mesenteric artery that appears embolic.

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